Understanding Normality and Abnormality in Psychology

Normality

Things that are accepted by society and don't differentiate from the norm.

Socio-cultural approach

Thoughts or feelings and behaviours that are according to society norms and socially acceptable.

Functional Approach

Thoughts, feelings and behaviours that allow an individual to cope effectively and successfully in their life.

Historical Approach

The change in what is considered to be accepted thoughts, feelings and behaviours in different places and settings.

Medical Approach

Defines thoughts, feelings and behaviours as abnormal if a diagnosis can be made and treatment prescribed.

Statistical Approach

Something is considered normal if it is in the majority and is rather an outlier.

Situational Approach

The change in what is considered to be acceptable thoughts, feelings and behaviours in different places and settings.

Deviance or Norm Violation

A behaviour that is deemed abnormal if it is deemed socially unaccepted.

Distress

People seek treatment if they experience abnormal behaviour. Therefore abnormal behaviour causes distress.

Dysfunctional

Maladaptive behaviour that interferes with a person's ability to perform everyday tasks.

Danger

Behaviours that pose risk to oneself and others.

Abnormality

Things that are not accepted by society and go away from the norm.

Mental Health

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.

Mental Disorder

Characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour.

National Survey of Mental Health and Wellbeing

A survey conducted by ABS in 2007 that reports on mental health statistics in Australia.

Mental Disorder Prevalence

45% of Australians aged 16-84 (7.3 million) have experienced a mental disorder at some point in their lifetime.

12 Month Disorder Experience

3.2 million Australians (1 in 5) experience one of the disorders in a 12 month period.

Access to Mental Health Services

Only 1/3 of individuals with mental disorders accessed mental health services, with women and the elderly more likely to do so.

Mental Health Related Prescriptions

4.3 million people received mental health related prescriptions in 2018-2019 (AIHW, 2020).

Diagnosis of Disorders

Identifying and classifying abnormal behaviour on the basis of symptoms, patient self-reports, observations, clinical tests, or information from relatives.

Psychological Assessment

Clinicians use psychological assessment and diagnostic manuals to make diagnoses.

Diagnostic Manual Purpose

The purpose of diagnosis is to find a treatment for the patient and to make a prognosis.

Diagnostic and Statistical Manual of Mental Disorders (DSM)

The gold standard for classifying mental disorders, currently containing 300 different mental disorders.

Categorical Approach

The DSM uses a categorical approach where the individual either has the disorder or does not have it.

DSM-IV-TR

The DSM-IV-TR was in use until 2013 and contained 5 axes for classification.

DSM-5

The DSM-5 no longer uses axes and includes adjustments to some classifications and newer identified disorders.

Validity and Reliability

If it's valid, it's a bullseye. Reliability is consistent.

All or Nothing Principle

A principle stating that a diagnosis is a qualitatively distinct clinical condition based on symptoms.

Strengths of Categorical Diagnosis

Facilitates communication, predicts future experiences, identifies prevalence rates, and documents public health information.

Weaknesses of Categorical Diagnosis

Includes overlap between symptoms, large incidence of co-occurrence, oversimplification, low inter-rater reliability, stigma, and self-fulfilling prophecy.

Dimensional Approach to Diagnosis

Quantifies symptoms or characteristics and represents them with numerical values on scales or continuums.

Dimensional Diagnosis Process

Diagnosis becomes about the degree to which a characteristic is present rather than simply deciding the presence of a symptom.

Dimensional Approach Question

The dimensional approach asks the question 'how much?' with lower scores equating to lower impairment.

Strengths of Dimensional Approach

Provides more detailed information on each symptom and considers a wider range of factors.

Strengths of Diagnosis

More detailed information on each symptom, takes into account a wider range of factors, and creates a profile instead of labelling.

Weaknesses of Diagnosis

Time consuming and no standard inventory to compare scores, making diagnosis difficult.

Correct Diagnosis and Treatment

Relates to the reliability and validity of diagnosis which are required for correct treatment.

Comorbidity

Many disorders are not easy to identify because they occur together with symptoms of other disorders.

Biases in Diagnosis

Biases such as gender, ethnicity, age, and confirmation bias can prevent correct diagnosis.

Culture and Diagnosis

Different cultural groups have different attitudes to psychological disorders that might influence the reporting of symptoms and diagnosis.

Cultural Bias in Diagnosis

Clinicians may not observe certain symptoms because they are not familiar with the expressions of distress in a particular culture.

Culture-bound Syndromes

These could be difficult to recognise for clinicians and may prevent people from being treated.

Reliability of Diagnosis

Clinicians should be able to reach the same correct diagnosis consistently if they use the same diagnostic procedure.

Standardised Clinical Interview Schedules

Can improve reliability by defining and specifying sets of symptoms to look for.

Introduction of Diagnostic Systems

Has improved the reliability of diagnosis.

Reliability as a Prerequisite for Validity

Reliability is necessary for validity in diagnosis.

Validity of Diagnosis

Refers to receiving the correct diagnosis, which should result in the correct treatment and prognosis.

Difficulty in Diagnosing Psychological Disorders

It is much more difficult to provide a correct diagnosis and prognosis for psychological disorders than for physical disorders.

Thomas Szasz

Argued that mental illness is a myth and critiqued the discipline of psychiatry.

The Myth of Mental Illness (1960)

Szasz suggested that many disorders should not be categorised as diseases and argued against the use of diagnostic systems.

Changing Nature of Disorders

Szasz's ideas demonstrate the changing nature of our understanding of what constitutes a disorder.

Blame for Mental Illness

Historically, we used to blame witches for things we couldn't understand; now we blame mental illness.

Absence of Cellular Cause

Szasz argued we cannot say mental illness exists as these experiences do not have a cellular cause.

Judging Abnormality

We cannot judge what is abnormal mentally as we do not have a clear understanding of what is anatomically and physiologically normal in psychiatry.

Normal Problems in Living

What we label as an illness may just be examples of normal problems in living.

Role of Psychiatrists

Psychiatrists assist individuals with 'problems in living' despite the controversy surrounding mental illness.

Medicalisation of Human Behaviour

The proliferation of new psychiatric disorders medicalises human behaviour, shifting responsibility from the individual to psychiatrists.

Attractiveness to Pharmaceutical Companies

The expanding medicalisation of mental illness is attractive to pharmaceutical companies.

Legal Responsibility and Diagnosis

Diagnosis could lead to the legal system finding that someone is not responsible for their actions.

Szasz's distinction

Szasz distinguishes between explanation and responsibility arguing that individuals are 'always responsible for their conduct'.

Mental disorders count

It was problematic that there were 7 mental disorders and now there are 300.

Sane in Insane Places

Study by David Rohsen in 1973 about how sane people claimed to hear certain words in insane places and were still considered to have abnormal symptoms upon discharge.

Stigma

The stigma that a normal person can become someone with abnormal symptoms.

Placebo

A term used in the context of psychological studies, often referring to the effect of believing in treatment.

Jailcell of insane places

A metaphor for how insane places store people you don't want or those who have lost a great deal of sympathy.

Elithabeth Cochran

A journalist whose saner behavior made her seem more abnormal.

Living conditions of hospitals

The living conditions of the hospitals were bad.

AIMS

AIMS stands for Psychiatric Labels, providing data for what it's like to be in an insane place.

Second experiment of Rohsenhan

In the second experiment, no pseudo patients were sent, but people were still suspected.

Langer & Abelson study

A 1974 study exploring confirmation bias and labeling with two groups of clinical psychologists.

Interview experiment

Participants watched an interview of a man discussing his feelings and experiences related to his past work.

Independent Variable (IV)

Half of participants were told the man was a 'job applicant' and the other half were told he was a 'patient'.

Dependent Variable (DV)

Participants rated the person according to how disturbed or well-adjusted he was.

Results of Langer & Abelson study

The analytic psychologists rated the man as more disturbed when they were told he was a patient.

Labeling effects

Changes in the words used to describe the man depended on his label.

Behavioral psychologists' ratings

The behavioral psychologists tended to rate the man as fairly normal, regardless of the label.

Historical bias in psychiatry

The study serves as a historical example of bias existing within the field of psychiatry.

Differences in psychological lens

Differences depending on psychological lens, e.g., behaviorists focus on outward signs of abnormal behavior versus analytics seeing mental illness as internal struggle.

Ahn, Novick & Kim (2003)

A more modern example based on Meehl's premise that understanding a patient's behavior makes them appear more normal.

Study participants

Study conducted with undergraduate & graduate students within clinical psychology.

Normality ratings

Participants rated how 'normal' a subject appeared based on the descriptions provided.

Plausible cause for behavior

When given information pointing towards a plausible cause for behavior and a negative life event, ratings of normality increased.

Implications of understanding behavior

Understanding someone's behavior tends to make it appear more normal, with implications for reducing stigma.

Rosenhan's study type

An observation of how insane people were treated and to gather data.

Disadvantages of Rosenhan's study

Some disadvantages include potential danger to participants and lack of accurate representation of all institutions.

Advantages of Rosenhan's study

Advantages include patients being treated under the same conditions as others and gaining a good understanding of stigma in insane places.

Results of Rosenhan's study

Results suggest that people were stigmatized with labels, making it hard to leave the institution.

Diagnosis challenges

Shows that people have trouble diagnosing mental disorders and are often treated poorly.

Validity of Rosenhan's conclusions

Comment on whether Rosenhan's conclusions are valid and the extent to which his findings can be generalized.

Categorical vs. Dimensional Approach

The controversy around using the categorical vs. dimensional approach to diagnose mental disorders, with the DSM-5 using a categorical approach.

Stigmatized Psychology Disorders

The issue of individuals wanting to understand their mental health to the degree it affects them rather than being labeled with a title.

Factors for Accurate Diagnosis

Important factors include ethics, validity, reliability, culture, and trained professionals who are unbiased in their assessments.

Clinical Judgment

The importance of not blindly following imperfect systems and using professional skills developed over time.

Advantages of DSM-5 Diagnosis

The system is simple, measurable, and does not take a long time to diagnose.

Revision of DSM

Necessary to update current research and definitions of psychological disorders from 2013.

Neurological Tests

Evaluating the brain through MRI scans to check for tumors, infections, and diseases causing abnormal behavior.

Clinical Interviews

Used to gather information on current habits, beliefs, attitudes, emotions, and problems for understanding behavior.

Psychology Tests

Tests measuring personality traits, including objective tests for specific answers and projective tests for responses to stimuli.

Purpose of Clinical Assessment

To help psychologists understand a person better, guide recovery, and diagnose psychological disorders.

Clinical Diagnosis

The identification of abnormal psychological symptoms and conditions based on past and current behavior and traits.